Practicing in Texas (and the associated heat, dust, etc) we get a lot of these. I always joke that its one of the most common things no one has ever heard of. Every time I say the word "pingueculitis" the patient inevitably replies "PINK EYE!!??" No, not pink eye. :D
A pinguecula is an inflammatory degeneration or degradation of the bulbar conjunctiva & sclera on the surface of the eye. Brought on by "exposure" to high heat, wind, & UV rays, the collagen fibers of the sclera & conjunctiva degrade and deformed elastin fibers are produced. The result is a yellow or off-white bubbly-appearing "bump" or raised lesion on the surface of the eye, usually nasally & temporally only (b/c the superior & inferior conjunctiva is generally protected by the eyelids).
Many, many patients see a pingucula on the surface of their eye, Google "yellow eyes" and come up with "jaundice". I first blogged about this in 2007 (reposted in 2009):
Jaundiced eyes are EXCEEDINGLY rare. Pinguecula is not.
But today we're discussing "pingueculitis" or inflamed pinguecula. The pinguecula is the bump. When the bump becomes irritated, red, painful & bothersome, we call it "pingueculitis". Here's how it usually presents:
the patient has a red, painful eye. They go to their PCP and are occasionally prescribed antibiotic eye drops (or maybe they use some eye drops they already had in their medicine cabinet). After 3-4 days of the "pink eye not going away", they present to our office with "pink eye that won't go away". That's of course because antibiotics kill bacteria, but will not solve an inflammatory problem.
The treatment of the acute pain & redness of pingueculitis is steroid eye drops. I usually Rx Lotemax when its mild and Pred Forte when its more severe. Steroids do not make the pinguecula any smaller or make it go away, they only make it not inflamed and remove the pain, redness & swelling. The only way to get rid of a pinguecula is to have it surgically excised.
Pinguecula formation is usually a response to UV rays & exposure that you got a long time ago. "A lifetime of sunshine" I always say. In other words, you won't develop a pinguecula from a weekend at the beach w/o sunglasses. More like LIVING on the beach w/o sunglasses. A lay term for pinguecula is "farmer's eye" b/c many farmers who don't wear sunglasses or hats or adequate sun protection develop these.
You CAN, however, get pingueculitis from a weekend at the beach w/o sunglasses. In other words, if you have a pre-existing pinguecula it can become inflamed (red, painful) after a particularly high dose of UV (or wind, or heat, etc). Even though its called "farmer's eye", BIKERS are at high risk of both pinguecula & pingueculitis because frequently they're out on their motorcycle in the high heat, wind & UV.
Active pingueculitis (red, painful - this is a mild case):
Other various presentations of non-inflamed pingueculae: